Antidepressant use may increase risk of strokes caused by bleeding in the brain

Research shows that use of popular antidepressants is linked to an increased risk of some strokes caused by bleeding in the brain, but that the risk is low, according to a multi-study analysis published in the October 17, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology.

For the research, scientists analyzed all of the studies that have looked at antidepressant use and stroke, which included 16 studies with more than 500,000 total participants. They found that people taking selective serotonin reuptake inhibitors (SSRIs), which are the most commonly used antidepressants, were 50 percent more likely to have an intracranial hemorrhage than those not taking the antidepressants and about 40 percent more likely to have an intracerebral hemorrhage.

But study author Daniel G. Hackam, MD, PhD, FRCPC, of Western University in London, Ontario, said the findings should be viewed with caution. "Because these types of strokes are very rare, the actual increased risk for the average person is very low," he said.

An estimated 24.6 of these strokes occur per 100,000 people per year. According to the research, the use of SSRIs would increase the risk by one additional stroke per 10,000 people per year.

"Overall, these results should not deter anyone from taking an SSRI when it is needed," Hackam said. "In general these drugs are safe, and obviously there are risks to having depression go untreated. But doctors might consider other types of antidepressants for people who already have risk factors for these types of strokes, such as those taking blood thinners, people who have had similar strokes already or those with severe alcohol abuse."

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